Relationship Of Social Support On Post-traumatic Stress Disorder In The Parents Of Children With Cancer:the Mediating Role Of Rumination

Objective:To investigate the status quo of PTSD,social support and rumination in parents of children with malignant tumor,to explore the relationship between PTSD and social support and rumination in parents of children with malignant tumor,and to explore the mechanism of social support and rumination in parents of children with malignant tumor on PTSD.Methods:From December 2020 to June 2021,243 parents of children with malignant tumor were selected from three grade III,Grade A hospitals in Jiangxi Province by convenient sampling method.The Chinese Version of the Perceived Social Support Scale(PSSS),the Chinese version of the Event Related Rumination Scale(ERRI),and the Chinese version of the Civilian Screening Scale for PTSD(PCL-C)were used to conduct the questionnaire System.Results:1.In this study,76(31.3%)parents of 234 children with malignant tumor had moderate or severe PTSD symptoms(PCL-C≥50 points),and 64(26.3%)had mild or moderate PTSD symptoms(38≤ PCL-C ≤ 49 points).The total score of PTSD in the parents of children with malignant tumor was(41.40±13.39)points,and all items were(2.35±0.80)points;The mean scores of the three dimensions from high to low were: reexperience(2.66±0.97),increased alertness(2.28±0.86),avoidance(2.18±0.86).2.The total score of parental social support for children with malignant tumor was(59.04±11.18)points,and all items were(4.92±0.93)points;The mean scores of the three dimensions from high to low were: family support(5.11±1.09),other support(5.11±0.99),friends support(4.54±1.08).3.The total score of ruminant thinking of parents of children with malignant tumor was(36.92±11.13)points,and all items were(1.85±0.56)points;Invasive regurgitation items were(1.96±0.68)points,active regurgitation items were(1.73±0.59)points.4.General demographic single factor analysis showed that there were statistical differences between parents of children with malignant tumor who experienced symptoms again,place of residence,occupational status,whether they were still working,monthly income,whether the child was the only child(P <0.05).There were statistically significant differences in avoidance symptoms of parents of children with malignant tumor in place of residence,whether they were still working at present,monthly income and whether the children had ever studied in school(P <0.05).There were significant differences in occupational status,whether the children were still working at present,monthly income,whether the children were the only child and whether the children had ever studied in school(P <0.05).5.There was a weak negative correlation between parents’ social support and PTSD(R =-0.303,P<0.001).Rumination was moderately positively correlated with PTSD(R =0.486,P<0.001).There was a weak negative correlation between social support and rumination(r=-0.271,P<0.001).6.The stepby-step multiple linear regression showed that average monthly household income,intrusive rumination and proactive rumination were the main influencing factors of reexperience.Current working,other support,intrusive rumination and proactive rumination were the main influencing factors of avoidance.Being present at work,intrusive rumination and other support were the main factors influencing alertness.7.Structural equation model of factors affecting PTSD in parents of children with malignant tumor showed that chi-square to degree of freedom ratio was 2.150,GFI、AGFI、 NFI、IFI、TLI and CTI were all greater than 0.900,RMSEA value was0.069.The RMR value is 0.035.The structural equation effect analysis showed that the direct effect value of parents’ social support on PTSD of children with malignant tumor was-0.15,and the indirect effect value of social support on PTSD through rumination was-0.178(-0.22*0.81),and the total effect value was-0.328.Conclusion:1.In this group,the parents of children with malignant tumor had a medium level of PTSD,and average monthly income,social support and rumination had a significant impact on PTSD of children with malignant tumor.2.Parents’ social support of children with malignant tumor can directly affect PTSD,and it can also indirectly affect PTSD through rumination,and the indirect effect is higher than the direct effect.And the external environmental factors are more easily affected by other factors than the internal factors of the individual,and more difficult to control.Therefore,in clinical work,intervention for PTSD of parents of children with malignant tumor can not only improve their social support network and improve the level of social support,but also start from reducing rumination of parents of children with malignant tumor.